Meta-analysis: Metformin Treatment in Persons at Risk for Diabetes Mellitus
Abstract Purpose We performed a meta-analysis of randomized controlled trials to assess the effect of metformin on metabolic parameters and the incidence of new-onset diabetes in persons at risk for diabetes. Methods We performed comprehensive English- and non–English-language searches of EMBASE, ME...
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Published in | The American journal of medicine Vol. 121; no. 2; pp. 149 - 157.e2 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Elsevier Inc
01.02.2008
Elsevier Elsevier Sequoia S.A |
Subjects | |
Online Access | Get full text |
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Summary: | Abstract Purpose We performed a meta-analysis of randomized controlled trials to assess the effect of metformin on metabolic parameters and the incidence of new-onset diabetes in persons at risk for diabetes. Methods We performed comprehensive English- and non–English-language searches of EMBASE, MEDLINE, and CINAHL databases from 1966 to November of 2006 and scanned selected references. We included randomized trials of at least 8 weeks duration that compared metformin with placebo or no treatment in persons without diabetes and evaluated body mass index, fasting glucose, fasting insulin, calculated insulin resistance, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and the incidence of new-onset diabetes. Results Pooled results of 31 trials with 4570 participants followed for 8267 patient-years showed that metformin reduced body mass index (−5.3%, 95% confidence interval [CI], −6.7-−4.0), fasting glucose (−4.5%, CI, −6.0-−3.0), fasting insulin (−14.4%, CI, −19.9-−8.9), calculated insulin resistance (−22.6%, CI, −27.3-−18.0), triglycerides (−5.3%, CI, −10.5-−0.03), and low-density lipoprotein cholesterol (−5.6%, CI, −8.3-−3.0%), and increased high-density lipoprotein cholesterol (5.0%, CI, 1.6-8.3) compared with placebo or no treatment. The incidence of new-onset diabetes was reduced by 40% (odds ratio 0.6; CI, 0.5-0.8), with an absolute risk reduction of 6% (CI, 4-8) during a mean trial duration of 1.8 years. Conclusion Metformin treatment in persons at risk for diabetes improves weight, lipid profiles, and insulin resistance, and reduces new-onset diabetes by 40%. The long-term effect on morbidity and mortality should be assessed in future trials. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-Review-3 content type line 23 |
ISSN: | 0002-9343 1555-7162 |
DOI: | 10.1016/j.amjmed.2007.09.016 |